title: [The heart: bystander or participant in neoplasms? The Hedinger syndrome (carcinoid cardiopathy)].
abstract: A case of a 38-years-old patient with carcinoid syndrome (paroxysmal skin flush, diarrhoea, abdominal pain) is documented although the search of the primary tumor was not able to localise it (possibly an intestinal one). Confirmatory diagnosis had a biochemical support in 262 mg/24 h urinary elimination of 5 HIAA (metabolic of serotonine). Particular aspects of the case are illustrated through intravitam documentation of the liver metastases (via portal vein) and the damage of the right heart (Hedinger syndrome) resulting from the involvement of the tricuspid valve apparatus (with clinical, phonomechanographic and echocardiographic abnormalities). The fatal evolution of the patient was due to uncontrolled aggravation of the portal high blood pressure syndrome (refractory ascites to diuretic treatment). It was impossible to us to obtain the morphopathological data. The specific elements of the carcinoid syndrome (including a convincing indirect illustration) with right cardiac involvement (known as Hedinger syndrome) are discussed, as well as the hypothetical place in pancreas of the primary carcinoid tumor.
authors.affiliation: Clinica I Medicală Cardiologică, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
authors.forename: I
authors.initials: I
authors.lastname: Bostaca
authors.forename: O
authors.initials: O
authors.lastname: Ciurea
authors.forename: M
authors.initials: M
authors.lastname: Jescu
mesh_terms: D000328:Adult; D002275:Carcinoid Heart Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006338:Heart Neoplasms / Q000556:secondary; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*
vernacular_title: Cordul: spectator sau participant în neoplazii? Sindromul Hedinger (cardiopatia carcinoidă).